Understanding Small Bowel Resection

1
Understanding Small Bowel Resection

• By Dr. Valeria Simone MD
• (Southlake General Surgery, Texas, USA)

2

• A small bowel resection is a surgical procedure
  involving removing a portion of the small
  intestine. This procedure is typically performed
  to treat conditions such as bowel obstruction,
  Crohns disease, tumors, or intestinal injuries.
• By removing the affected section of the small
  intestine, small bowel resection aims to
  alleviate symptoms, restore normal bowel
  function, and improve the patients overall
  health.

3
Key Highlights

• A small bowel resection is a surgical procedure
  involving removing a portion of the small
  intestine.
• This procedure is specifically designed to
  address severe gastrointestinal (GI) conditions.
• This procedure is typically performed to treat
  conditions such as bowel obstruction, Crohns
  disease, tumors, or intestinal injuries.
• By removing the affected section of the small
  intestine, small bowel resection aims to
  alleviate symptoms, restore normal bowel
  function, and improve the patients overall
  health.
• Patients need to be aware of these potential
  complications and promptly report any concerning
  symptoms to their healthcare provider for
  appropriate management.
• Regular follow-up appointments with their
  healthcare team are crucial for ongoing
  monitoring and support post-surgery.

4
Overview of Small Bowel Resection

• A small bowel resection is a surgical procedure
  that is commonly performed to treat various
  conditions affecting the small intestine. It
  involves the removal of a portion of the small
  intestine that is diseased or damaged, allowing
  for the restoration of normal bowel function.
• This procedure is typically recommended when
  other treatment options, such as medication or
  dietary changes, have been ineffective in
  managing the underlying condition. Expert
  surgeons who specialize in gastrointestinal
  procedures frequently perform small bowel
  resections, ensuring the best outcome for the
  patient. Small bowel resections are typically
  performed as a last resort.
• During the procedure, the surgeon will make an
  incision in the abdomen to access the small
  intestine. They will carefully remove the
  affected section of the small intestine, taking
  care to preserve the healthy tissue.
• After the removal, the surgeon will then connect
  the remaining sections of the small intestine to
  ensure the continuity of the digestive tract.
  This may involve sutures or the use of
  specialized stapling devices.
• Once the procedure is complete, the incision will
  be closed, and the patient will be closely
  monitored during the recovery period.

5
Importance of understanding the procedure

• Understanding the procedure is crucial for
  patients and their families to make informed
  decisions about their healthcare. It allows them
  to have realistic expectations about the surgery
  and its potential outcomes.
• Additionally, understanding the procedure can
  help alleviate anxiety and fear, as patients will
  have a clear understanding of what to expect
  during the surgery and recovery process. It also
  enables patients to actively participate in their
  care by asking questions, voicing concerns, and
  following post-operative instructions more
  effectively.
• Overall, having a comprehensive understanding of
  the procedure promotes better communication
  between the patient and healthcare providers,
  leading to a more successful surgical experience
  and improved patient outcomes.

6
Who needs a Small Bowel Resection?
7

• This procedure is specifically designed to
  address severe gastrointestinal (GI) conditions.
  Here are some examples Crohns disease, bowel
  obstruction, perforation, and tumors.
• Incarcerated abdominal hernia, which occurs when
  a portion of the intestine becomes trapped in the
  abdominal wall, is another condition that may
  necessitate a small bowel resection.
• Abnormal growths, such as polyps or cancerous
  tumors, can also be a reason for a small bowel
  resection.
• Necrotizing enterocolitis, a serious condition
  that primarily affects premature infants, can
  also lead to the need for a small bowel
  resection. In cases where the small bowel becomes
  twisted or obstructed, a resection may be
  necessary to restore normal bowel function and
  prevent further complications.
• Congenital GI disorders, such as intestinal
  malrotation or Meckels diverticulum, may also
  require a small bowel resection.
• Chronic inflammatory GI issues, such as
  ulcerative colitis or diverticulitis, can also be
  treated with a small bowel resection.
• Trauma or perforation, such as from a gunshot or
  knife wound, can also necessitate a small bowel
  resection. In these cases, the injured portion of
  the small bowel may need to be removed to prevent
  infection or further damage to the surrounding
  organs. Prompt surgical intervention is crucial
  to repair the perforation and prevent
  life-threatening complications such as
  peritonitis.
• Small bowel obstruction, often caused by
  adhesions or tumors, can also be a reason for a
  small bowel resection. In this condition, the
  passage of digested food through the small
  intestine is blocked, leading to severe pain,
  vomiting, and an inability to have a bowel
  movement. Surgery is usually required to remove
  the obstruction and restore the normal flow of
  digestion.

8
What are the symptoms and complications that may
indicate the need for surgery?
9

• Symptoms and complications that may indicate the
  need for small bowel resection surgery include
• 1. Perforation If there is a perforation in the
  small intestine, it can lead to life-threatening
  complications such as peritonitis. Surgery is
  necessary to repair the perforation and prevent
  further complications.
• 2. Small bowel obstruction Adhesions or tumors
  can cause a blockage in the small intestine,
  leading to symptoms like severe pain, vomiting,
  and an inability to have a bowel movement.
  Surgery is typically required to remove the
  obstruction and restore normal digestion.
• 3. Inability to pass digested food If there is a
  blockage in the small intestine, it can prevent
  the passage of digested food through the
  digestive tract. This can result in severe pain,
  vomiting, and an inability to have a bowel
  movement. Surgery is usually needed to remove the
  obstruction and allow for proper digestion.
• 4. Complications of adhesions or tumors
  Adhesions or tumors in the small intestine can
  lead to complications such as bowel perforation,
  abscess formation, or intestinal bleeding. These
  complications may require surgical intervention,
  including small bowel resection.
• 5. Unsuccessful non-surgical treatments In cases
  where non-surgical treatments such as medication
  or dietary changes have not been successful in
  relieving symptoms or resolving complications,
  surgery may be necessary.
• 6. Diagnosis of underlying conditions If an
  underlying condition such as Crohns disease or
  cancer is diagnosed and causing significant
  damage to the small intestine, surgery may be
  recommended as part of the treatment plan.
• It is important for patients experiencing these
  symptoms or complications to consult with a
  medical professional who can evaluate their
  condition and determine if small bowel resection
  surgery is necessary for their case.

10
What are the diagnostic tests used to determine
the need for a small bowel resection?
11

• 1. Physical examination A medical professional
  may conduct a physical examination to assess the
  patients symptoms, such as abdominal pain,
  bloating, or changes in bowel movements.
• 2. Blood tests Blood tests can help identify any
  abnormalities that may indicate an underlying
  condition or inflammation in the small intestine.
• 3. Imaging tests Various imaging tests may be
  used to visualize the small intestine and detect
  any abnormalities or complications. This may
  include
• X-ray A simple X-ray can provide initial
  information about the condition of the small
  intestine.
• CT scan A computed tomography (CT) scan can
  provide detailed images of the small intestine
  and help identify any structural abnormalities or
  complications.
• MRI Magnetic resonance imaging (MRI) uses
  powerful magnets and radio waves to create
  detailed images of the small intestine.
• Capsule endoscopy This involves swallowing a
  pill-sized camera that takes pictures as it
  travels through the digestive system, allowing
  for a thorough examination of the small intestine.

12

• 4. Endoscopic procedures These minimally
  invasive procedures involve inserting a flexible
  tube with a camera into the digestive tract to
  evaluate the small intestine. This may include
• Upper endoscopy (esophagogastroduodenoscopy)
  This procedure involves inserting a flexible tube
  through the mouth to examine the upper part of
  the digestive tract, including the small
  intestine.
• Colonoscopy While primarily used to examine the
  colon, a colonoscopy can also provide information
  about certain conditions affecting both the large
  and small intestines.
• Balloon-assisted enteroscopy This specialized
  endoscopic procedure allows for visualization and
  potential intervention within specific parts of
  the small intestine.
• 5. Biopsy In some cases, a tissue sample
  (biopsy) may be taken during an endoscopic
  procedure to further investigate any suspicious
  findings or confirm a diagnosis.
• 6. Consultation with specialists Depending on
  individual cases, medical professionals may
  consult with other specialists, such as
  gastroenterologists or surgeons, to determine the
  need for small bowel resection based on the
  results of the diagnostic tests.

13
What are the Preoperative Preparations for a
small bowel resection?
14

• Preoperative preparations for a small bowel
  resection may include
• 1. Evaluation The patient will undergo a
  thorough evaluation to assess their overall
  health and determine if they are a suitable
  candidate for surgery.
• 2. Medical history The medical team will review
  the patients medical history, including any
  previous surgeries, current medications, and
  known allergies or medical conditions.
• 3. Laboratory tests Blood tests may be performed
  to check for any underlying health conditions or
  abnormalities that could affect the surgery or
  recovery process.
• 4. Imaging studies Imaging tests such as X-rays,
  CT scans, or MRI scans may be ordered to obtain
  detailed images of the small intestine and
  surrounding structures to help plan the surgical
  procedure.
• 5. Bowel preparation The patient may need to
  follow specific instructions for bowel
  preparation, which typically involves taking
  laxatives or undergoing a bowel cleansing
  procedure to ensure the intestines are clean
  before surgery.
• 6. Medications The medical team will review the
  patients current medications and advise on which
  ones should be continued or temporarily stopped
  before the surgery. This includes discussing
  blood thinners and antibiotics.
• 7. Fasting The patient will typically be
  instructed not to eat or drink anything for a
  certain period before surgery, usually starting
  at midnight on the night before the procedure.
• 8. Discussion of risks and benefits The surgeon
  will have a detailed discussion with the patient
  about the potential risks and benefits of the
  small bowel resection procedure, as well as what
  they can anticipate during and after surgery.
• 9. Consent forms The patient will be required to
  sign consent forms acknowledging that they
  understand the procedure and its risks and that
  they agree to proceed with it.
• 10. Preoperative instructions The medical team
  will provide specific instructions regarding when
  to arrive at the hospital, what to wear, any
  personal items that should be brought along, and
  other logistical details related to the day of
  surgery.

15
Small Bowel Resection Procedure
16

• During a small bowel resection procedure, the
  surgeon will remove a portion of the small
  intestine that is diseased or damaged. This can
  be done using either a laparoscopic or open
  approach.
• 1. Laparoscopic Surgery In this technique,
  several small incisions are made in the abdomen.
  The surgeon will then insert a laparoscope (a
  thin tube with a camera) and other surgical
  instruments through these incisions. A
  laparoscope enables the surgeon to have a clear
  view of the surgical site through a monitor.
• 2. Open Surgery In an open approach, a larger
  incision is made in the abdomen to access the
  small intestine directly. This provides the
  surgeon with more direct visualization and access
  to the affected area.
• 3. Preparation Before surgery, patients will
  need to follow preoperative instructions provided
  by the medical team. This may include fasting for
  a certain period of time before surgery, stopping
  certain medications, and completing any necessary
  preoperative tests or evaluations.
• 4. Anesthesia Before the procedure begins,
  anesthesia will be administered to ensure that
  the patient is comfortable and pain-free during
  surgery. The type of anesthesia used will depend
  on various factors, such as patient preference,
  medical condition, and the surgeons
  recommendation.
• 5. Incision and exposure Once anesthesia takes
  effect, the surgeon will make either several
  small incisions (laparoscopic approach) or one
  larger incision (open approach) in the abdomen to
  gain access to the small intestine.
• 6. Resection The diseased or damaged section of
  the small intestine will be carefully located and
  removed by either cutting it out (resection) or
  bypassing it with sutures (anastomosis). The
  remaining healthy portions of the intestine are
  then reconnected, if necessary.
• 7. Closure After removing or bypassing the
  affected area, the surgeon will close any
  incisions made during the procedure using sutures
  or staples.

17
Recovery and Postoperative Care
18

• After a small bowel resection, what can I expect?
• After a small bowel resection, you can expect the
  following
• 1. Recovery in a monitored area The patient will
  be closely monitored in a recovery area until you
  wake up from anesthesia.
• 2. Pain management Pain medication may be
  prescribed to help manage any discomfort you may
  experience.
• 3. Antibiotics You may be prescribed antibiotics
  to prevent any infections.
• 4. Detailed postoperative instructions The
  medical team will provide detailed instructions
  regarding your diet, activity restrictions, wound
  care, and medication management.
• 5. Activity restrictions You may be advised to
  avoid strenuous activities and heavy lifting for
  a certain period of time.
• 6. Wound care You will need to follow specific
  instructions on how to care for your incision
  site.
• 7. Follow-up appointments You will likely have
  follow-up appointments with your surgeon to
  monitor your progress and address any concerns or
  complications that may arise.

19
After a small bowel resection, how much time does
one typically need to recover?

• Recovery from a small bowel resection can vary
  depending on individual factors, but it typically
  takes several weeks to a few months. The medical
  team will provide detailed instructions on how to
  aid in your recovery, including diet
  recommendations, activity restrictions, wound
  care, and medication management.
• It is important to follow these instructions
  closely and attend follow-up appointments with
  your surgeon to monitor your progress and address
  any concerns or complications that may arise
  during the recovery process.

20
Potential Complications and Risks

• Common complications and risks that may arise
  after small bowel resection include
• Lets explore more Understanding Small Bowel
  Resection - Southlake General Surgery

21
Appointment

• For more information on Small Bowel Resection.
  You can contact our healthcare expert today at 1
  [phone]. You can also make an online
  appointment with us.

22

• Medically Reviewed By Dr. Valeria Simone MD
• Board-certified General Surgeon at Southlake
  General Surgery, Texas, USA.
• Follow us on Facebook and YouTube.
• Source Understanding Small Bowel Resection -
  Southlake General Surgery

23
THANK YOU!
SOUTHLAKE GENERAL SURGERY
1545 E. Southlake Blvd, Suite 270 Southlake, TX
76092
EMAIL info_at_southlakegeneralsurgery.com
VISIT US AT www.southlakegeneralsurgery.com